Medicine teaches that asystole after doing effetive CPR with 15 compressions and 2 breathes with a lack of pulse means that the patient has expired. I have not yet been involved in this part of the physician's job for which I have been traied, dread and continously rehearse in my head in any uncertain situation, thinking that if a physician is there, s/he should know what to do and save someone's life.
The first time that I witnessed a death after a failed CPR was vicariously. I was on pnimit chet, in one room, waiting for a doctor to finish his round so that I could ask him a question about a patient of mine who was on that ward. I had been following that patient up since having seen him in the emergency room, and was told that he was a usual "chronic abdominal pain", possibly malingering. Still, I did not want to give up on my patient.
Standing near the group of doctor rounding, looking at an old patient in bed, listening to the discussion in Hebrew, behind me, another group of physicians dressed in white coats walked out. By the lifeless look on their faces and heavy footsteps, I intuitively knew something was different in that room. I was not familiar with the patients on the ward and was only there to check on my own patient. A few minutes later, two women ran into the room, passed me, removed a closed curtain, and one women threw herself on the floor, crying, sobbing, very loudly.
I finally dared to look beyond the curtain that was removed, a man in his fifties was dead, perhaps due to cardiovascular reasons, whether he also was an oncologic patient, I cannot remember. He lied there, at the corner of the bed, with blood still present in his own warm body, and yet, he was lifeless. The medical team had walked away from a failed resusiciation. And now the family members were mourning. I later went into the medical personnel's room, and heard small chatter, "He died too young, perhaps there was a mistake we made and we could have saved him." I write those words in one sentence today, and yet I heard them intermittently as I flipped through my own patient's chart.
I remember leaving the room where the man was pronounced dead very quietly, having collected myself, and taken in a deep breath in, hoping to protect my own breath from lifeless death. And, I never thought about it again, until today when my own parents called me, telling me that a family friend's mother passed away on sunday (today is monday).
I had known the family friend since coming to Beer Sheva three years ago. She is a mother of three, and I frequented her house, either to have a drink, to help with her child's homework, or to just chat. My last visit to her house, I remember her being not as lively and as optimistic as usual. And being the corward that I am, who is not able to bring things up to people, who is too afraid and too insecure to approach people's feelings and experiences, I sipped my coffee, and helped the mother with her homework for a test.
Much like having collected the news about the patient that died on the ward in pieces, I also collected the pieces of informatiom about my friend's dying mother in pieces. She was diagnosed with colon cancer years ago, went into remission after therapy (which I am not sure which because i was afraid to ask), but now, the oncologist told my friend's mother that nothing could be done for her anymore. Since then, my friend noticed that her rmother changed, did not talk much on the phone, and did not cook as before, which she used to like. I have realized over the years that I lack the ability to listen to someone, and be silent, but also asking the simplest questions to understand. Much like having been trained in medeicine to expect myself to know the answers and only ask purposeful questions, I approached my friend's grief like that.
There is no place for a wandering question in search of understanding in my own world of medicine. I feel uncomfortable when people talk about their feelings, especially in critical moments, such as death and dying.
I left my friend's house thinking, "Well, perhaps her mother does not have to suffer. She told me her mother is in pain. What can I do as a medical personnel?" Memories of the suffering of both my grandparents, sitty Im Saleem and Sido, came to mind, and how I wished that we had been able to provide relief from their pain and suffering. I contacted a family doctor in the negev who does palliative care, met with him, asked him how to approach my friend, what to ask, how to help her mother who was in pain, in the context of the Arab culture.
Dr. Yoram sat in his chair in the faculty building, listening to me quietly. He, then, said that not everything is connected to culture, that each individual values certain things and would like to keep them, and about that he asked his patients. I left knowing that I also had those questions for my friend about her mother, and then from there, perhaps palliative care could be provided.
A few days later, after fearing the phone call with my friend, I called her, told her what the doctor told me, and she said that she was going to get back to me. I never called her back again, even though she and her mother came through my mind, but I was too afraid to ask again, in the face of my friend's overwhelming sadness and hard situation that I could not fix, or explain or change.
And today, my mother called me, reminding me of the never ending rehearsal of emergency CPR i do in my head and try to forget about, "Her mother's died. You are near Nazareth, you should go." In the face of a death and a loss that were so familiar to me on the hospital ward, I was even more afraid. Why didnt I call my friend over time? Why didnt I check on her mother? And, if i call her now, what will I tell her on the phone? I am still afraid of facing my feelings, and people's feelings and life-events.
"The burial is at 4pm in the Orthodox church in Nazareth," a family friend answered me on the phone. It is almost easier for me to remain far away, not to see my friend grief. Have I not stayed away the past few weeks? And, as I am doing a family rotation, I am coming to perhaps appreciate that death does not spare anyone, and that instead of walking away from it with cold feet like the medical team did on pnimit chet, I should perhaps approach it, silentely, in awe, and give myself to this part of life, and put my fear aside. In the face of war and conflict, courage is being afraid and yet not giving in to fear of the highly inevitable but still going through till the very end, regardless of the outcome, of the myriad of feelings that are hard to contain, comprehend.
I would like to be courageous, rather than have fear of what I dont understand and perhaps will never understand rule over me. I am going to my friend's mother's funeral, because I dont want to be afraid anymore and yet will forever embrace my feeling of awe and wonder. I am bold to say: I dont understand. Maybe I never will, but I am fully present, to tell the stories, hence by being a witness, becoming a story-teller.
Thursday, June 25, 2009
The streets of Nazareth by me
One day, I will be good at knowing what signs mean, which buses to take, where streets, places and cities are located. When that day will be, I dont know. For now, it would seem that I am best at remaining in a state of wonder, and awe, travelling on roads, reaching places, only by admitting that I am lost and asking people. Such was the state I found myself in trying to reach Nazareth for my friend's mother's funeral. I had asked which bus to take from Migdal haemek to reach Nazareth. I tried to get an exact address of where the church was and my friend's family's house. "Just get to el-ayn (the fountain). Ask for the family of Jareysseh.
"What do I do with such directions? No name of a street. No idea of where south, north, west and east where, or even which parts of Nazareth. The first van I took turned out to only go to Nazareth Illit, not Nazareth. "I will drop you off here, and you can take bus number 1," said the driver. Drop me where exactly? I thought. I sat at the other bus station, with cars filling the tight streets, storesof cars, tires and furniture with signs writen in Arabic, waiting, for a bus. Typical for families around the Nazareth area who pass their business to their children.
“Amarah,” answered the seller when I asked him the name of the neighborhood where I was waiting for the bus. I walked out of the store for furniture, thinking about the answers I told the seller, “Yes, I am not from here, so I don’t know what the name of this place is.” Bus number one arrived to the bus-stop. “Do you speak Arabic, are you going to Nazareth?” An old man in his fifties answered yes. I rode with a combination of frustration and faith. Nazareth is big, for someone who is not from there, and has no exact directions or name of a street.
The bus seemed to enter heavy traffic, and I remembered from my childhood years that driving through Nazareth took so much time because of the tight streets, the many cars, and people crossing in between. The bus stopped twice, and the second time, the bus driver got off, handing off the shift to another driver. “She is going to El ayn,” said the bus driver to the one replacing him. Was I in safe hands?
I remember a name of El Ayn since my childhood. There Mary, the mother of Jesus, and other women used to get their water, and thus the name fountain came. There used to be a Greek Orthodox church there that I had visited as a child, and used to listen to the ringing of the bells. The fountain and the church accompanied each other: There was a big courtyard in which the fountain was to believed to exist, and next to it was the church. I had always imagined Mary and the other women getting the water they needed, carrying it on their heads in jars to go back to their houses. On other days, the women may have also washed the clothes there, chatted, gossiped, the same way women do today at many social events. At the time, I had either gone there to visit the church as a historical site, or locate a restaurant near there. Now, twenty years later, I was going to the same place, for different reasons. Will I recognize upon reaching that this was el Ayn?The bus driver stopped and told me that I reached my destination.
Nazareth being on a hill, I trusted paths that seemed to go up. Walking I heard some bells ringing. I did not know how far I was from my friend’s house, where exactly I was, but I wanted to run to the safety that hearing bells brought. I stopped, asking the priest if I could ring the bell. The answer was no. “Where is the jaryessey house?” I asked a shopkeeper near the church. “Oh, you are asking because of the family member who passed away? Go up the hill a bit more, it is there,” the man answered. People usually want to stay with their own family in Nazareth, and hence end up building floors on top of each other. The hill up which I went was no different: how many siblings lived in the same building? I wondered.
The crowdedness of buildings on top of a hill reminded me of those in Bethlehem: in both cities families wanted to stay near each other but had no space to expand horizontally. I saw a paper hanging on a wall of a building, saying when Mary Jaraysee’s funeral was. I had found my sought building and went up two floors. Dressed in a pair of gray pants, and a button up shirt, not from Nazareth, I was not sure how the customs went. Women sat on the second floor, and men sat together on the first floor.
On the second floor, women were sitting on chairs, chatting, dressed in black and white clothes. I inquired where my friend was, and went into the kitchen to see her. She was dressed in black, introduced me to her other two sisters that I had long heard about. We then went to be in the sitting room, where she began telling me that her mother passed away on Sunday "even though" she had spent the weekend with her. Her mother was taken to the hospital on Saturday night where the family was told that her mother was dying but her death could happen from day 0 to a 100 days. So, she went back to be with her children and then come back to be with her mother. The time in between was when her mother passed away. “I was with her, and her hands were filled with water, and she was gasping for air,’ my friend said. “Why does water come out?” she asked, being a mathematician herself.
Not sure what to say or how to explain the path physiology of edema in a metastasized colon cancer mother, I opted for a simple answer, “There are many reasons why that could be.” The priest from the Orthodox church down the hill came up to the room. All the women stood up as he began to speak and pray. “ People live day to day, they have spirit but there is also the holy spirit that we cannot forget. Let’s pray for Mary’s spirit,” the priest said. It was the same priest that denied me the ringing of the bells, saying that I was not a priest myself. And after having heard about the last of days for my friend’s mother, and the suffering that she went through, I put on my own black dress that a priest wears- that of suffering.
Unfortunately, such a dress is invisible, and does not allow me to ring bells at churches. It was around 3pm, lunch time. It is customary to feed those who come to give their condolences. I stepped into the kitchen where the women were discussing how much rice and meet to hear, how much to send downstairs to the men, how many spoons and plates and yogurt were needed. There we stood in Mary’s kitchen, though she was not present, her cooking utensils and oven were.
And even though I had wanted to ring bells at churches, listening to the women organize the meal, I knew that I was not different than those women at El Eyn who met Mary, cleaning, collecting water, organizing matters. Hearing the clatter of the spoons on the plates, and then women discussing what temperature the oven should be on to heat the food, I knew that I will always ring a different kind of bells, at a different kind of church.
Medical professionals take comfort and pride in their competence and expertise. I highly doubt that with any kind of training and education, I will be able to read maps well, navigate in towns through street names, and explain that A leads directly to B. It seems that I will always be present amidst loss, chaos, and seem like a visitor from another town, asking the inhabitants where I am at.
Medicine is no different for me: I take comfort not in my own expertise or competence but rather in my continuous state of wonder, and hence collecting waters from fountains and ringing bells of stories at churches of people’s life, while wearing the invisible embroidered dress of suffering.
May Mary's soul rest in peace.
"What do I do with such directions? No name of a street. No idea of where south, north, west and east where, or even which parts of Nazareth. The first van I took turned out to only go to Nazareth Illit, not Nazareth. "I will drop you off here, and you can take bus number 1," said the driver. Drop me where exactly? I thought. I sat at the other bus station, with cars filling the tight streets, storesof cars, tires and furniture with signs writen in Arabic, waiting, for a bus. Typical for families around the Nazareth area who pass their business to their children.
“Amarah,” answered the seller when I asked him the name of the neighborhood where I was waiting for the bus. I walked out of the store for furniture, thinking about the answers I told the seller, “Yes, I am not from here, so I don’t know what the name of this place is.” Bus number one arrived to the bus-stop. “Do you speak Arabic, are you going to Nazareth?” An old man in his fifties answered yes. I rode with a combination of frustration and faith. Nazareth is big, for someone who is not from there, and has no exact directions or name of a street.
The bus seemed to enter heavy traffic, and I remembered from my childhood years that driving through Nazareth took so much time because of the tight streets, the many cars, and people crossing in between. The bus stopped twice, and the second time, the bus driver got off, handing off the shift to another driver. “She is going to El ayn,” said the bus driver to the one replacing him. Was I in safe hands?
I remember a name of El Ayn since my childhood. There Mary, the mother of Jesus, and other women used to get their water, and thus the name fountain came. There used to be a Greek Orthodox church there that I had visited as a child, and used to listen to the ringing of the bells. The fountain and the church accompanied each other: There was a big courtyard in which the fountain was to believed to exist, and next to it was the church. I had always imagined Mary and the other women getting the water they needed, carrying it on their heads in jars to go back to their houses. On other days, the women may have also washed the clothes there, chatted, gossiped, the same way women do today at many social events. At the time, I had either gone there to visit the church as a historical site, or locate a restaurant near there. Now, twenty years later, I was going to the same place, for different reasons. Will I recognize upon reaching that this was el Ayn?The bus driver stopped and told me that I reached my destination.
Nazareth being on a hill, I trusted paths that seemed to go up. Walking I heard some bells ringing. I did not know how far I was from my friend’s house, where exactly I was, but I wanted to run to the safety that hearing bells brought. I stopped, asking the priest if I could ring the bell. The answer was no. “Where is the jaryessey house?” I asked a shopkeeper near the church. “Oh, you are asking because of the family member who passed away? Go up the hill a bit more, it is there,” the man answered. People usually want to stay with their own family in Nazareth, and hence end up building floors on top of each other. The hill up which I went was no different: how many siblings lived in the same building? I wondered.
The crowdedness of buildings on top of a hill reminded me of those in Bethlehem: in both cities families wanted to stay near each other but had no space to expand horizontally. I saw a paper hanging on a wall of a building, saying when Mary Jaraysee’s funeral was. I had found my sought building and went up two floors. Dressed in a pair of gray pants, and a button up shirt, not from Nazareth, I was not sure how the customs went. Women sat on the second floor, and men sat together on the first floor.
On the second floor, women were sitting on chairs, chatting, dressed in black and white clothes. I inquired where my friend was, and went into the kitchen to see her. She was dressed in black, introduced me to her other two sisters that I had long heard about. We then went to be in the sitting room, where she began telling me that her mother passed away on Sunday "even though" she had spent the weekend with her. Her mother was taken to the hospital on Saturday night where the family was told that her mother was dying but her death could happen from day 0 to a 100 days. So, she went back to be with her children and then come back to be with her mother. The time in between was when her mother passed away. “I was with her, and her hands were filled with water, and she was gasping for air,’ my friend said. “Why does water come out?” she asked, being a mathematician herself.
Not sure what to say or how to explain the path physiology of edema in a metastasized colon cancer mother, I opted for a simple answer, “There are many reasons why that could be.” The priest from the Orthodox church down the hill came up to the room. All the women stood up as he began to speak and pray. “ People live day to day, they have spirit but there is also the holy spirit that we cannot forget. Let’s pray for Mary’s spirit,” the priest said. It was the same priest that denied me the ringing of the bells, saying that I was not a priest myself. And after having heard about the last of days for my friend’s mother, and the suffering that she went through, I put on my own black dress that a priest wears- that of suffering.
Unfortunately, such a dress is invisible, and does not allow me to ring bells at churches. It was around 3pm, lunch time. It is customary to feed those who come to give their condolences. I stepped into the kitchen where the women were discussing how much rice and meet to hear, how much to send downstairs to the men, how many spoons and plates and yogurt were needed. There we stood in Mary’s kitchen, though she was not present, her cooking utensils and oven were.
And even though I had wanted to ring bells at churches, listening to the women organize the meal, I knew that I was not different than those women at El Eyn who met Mary, cleaning, collecting water, organizing matters. Hearing the clatter of the spoons on the plates, and then women discussing what temperature the oven should be on to heat the food, I knew that I will always ring a different kind of bells, at a different kind of church.
Medical professionals take comfort and pride in their competence and expertise. I highly doubt that with any kind of training and education, I will be able to read maps well, navigate in towns through street names, and explain that A leads directly to B. It seems that I will always be present amidst loss, chaos, and seem like a visitor from another town, asking the inhabitants where I am at.
Medicine is no different for me: I take comfort not in my own expertise or competence but rather in my continuous state of wonder, and hence collecting waters from fountains and ringing bells of stories at churches of people’s life, while wearing the invisible embroidered dress of suffering.
May Mary's soul rest in peace.
Clinica day patient exposure and sampling by me
Dr. Orez brings her in from the internal ward, one more patient to be interviewed by the eager first year medical students. They call themselves by now 1/8th MDs.
Around the conference table sat the eight students in their white coats, with a clinical book passed around to read about the previous patient and her case: scleoderoma.
Um Salem walked in, a short lady, with her head covered, not wearing the regular hospital gown, small arms and feet, round trunk, low voice. She sat at the edge of the chair, put her elbow on the table across from me. There was an air of loss around her: the world barely seemed to exist. The other 10 persons in the room were almost not there to her. She was only brought in to leave as soon as she could.
I speak Arabic, surely, the only Arabic speaker in my group. Shouldn't I be the one to interview her? There is no language barrier and I should be able to understand what Um Salem says.
What steps to keep in mind? At this point of our training, it is supposed to be history of present illness, social and medical history, allergies, medications, family history. Drugs. Okay, I can do this. I think to myself.
After slowly explaining who I am, who the students are, the purpose of our interview, I ask what her name is.Does she understand my accent? Does she remember my name? Is she curious about where I come from? Why I speak Arabic and why my accent is different? None of this seems to matter to Um Salem- she is barely with me in the room as I would ask her questions; she barely maintains eye contact, as she looks throughout the window, around the room, and mutters a few words repeatedly: diabetes, high blood pressure and pain. Do I make my questions more specific? Do I leave it open ended? None of the techniques seem to work and I have no idea what kind of a person is sitting in front of me.
For the first time, I realize when a patient walks into the room, s/he brings more than a disease, a complaint or a cough. S/he brings in a story of the environment of where s/he lives, other people's stories, behaviors and cultures. Pain. Diabetes. High blood pressure. Tin houses. Yes, tests. Then she began coughing.
A classmate tells me, "Ask her for long she has been coughing."A week. The logs....she says. And then our doctor explains what was known as the "Bedouin lung", that because women cook using logs, they breathe in different chemicals, rendering them susceptible for pulmonological complications. Um Salem lives in a tin house, cannot use the logs to stay warm, cannot cook, and has people bring her food. She has been to the hospital before because of breathing problems.
The many words that I have used in Arabic trying to understand her story are not going to provide me with the picture of where Um Salem lives, nor is she going to explain to me about her environment. We come from totally different worlds- and even though I have explained who I am, who the students are, I am not sure that it make any sense to her. I am not sure that my questions about her health, my description of her pain, and her condition make sense to her, at all.
We both speak Arabic and yet the language seems to be common symbols for different meanings, worlds, experiences and lives. After seeing other Israeli patients who are active, who exercise, who do folk dancing, who wanted to get better- Um Salem highlights a complete opposite of the previous realities. Living in a tin house, with no electricity, no running water, not being able to cook, at the age of 70, with certain diseases. How did the world come to be to her?
Another classmate says, "Ask her, Has she been to a local healer?"But, how do I ask her this? It seems that even though the Bedouin population is different than the people in the city, they always use the health care system. She had given birth to all of her children at the hospital. What would I ask her? Do you go see a sheikh so that he makes you feel better? Does he do seher (magic)?
There is no way to translate the question applicable to parts of Africa or South America to Um Salem's situation and language. When you started feeling bad, who did you see first?Kopat Chulim. el mirpaha. Sounding the most awkward and the craziest perhaps to Um Salem, I ask her if she saw a sheikh, knowing that my question does not ask about the same idea that my classmates have in mind.As the interview ends, we, the medical students, have an idea of what her medical condition is and what it is induced by perhaps.
Yet, as she left, I am not sure that I completely understand what Um Salem's diseases is, what she thinks it is, how she comes to see it and experience it. Her lung case, if that is the case, seems to be as unimportant to her as the entire interview. I see her walk out of the room, realizing that though we seem to communicate, I do not know or understand the first thing about her, that though the doctors might give her antibiotic, she probably does not have any idea about what is injected in her and why. If I countmy days by numbers and calendars, she might count hers by the time left for her in the hospital before she leaves. Or, she might never count anything at all. To live in world with no numbers- Possible. I smile As Um Saleem walks away. Um Salem: Sometimes, the spirit of the desert cannot be captured in words, understood or felt. And the grains of sand are not perhaps meant to be measured and counted. Pain. Diabetes. High blood pressure- this is all there was to it. She is right. And I am humbled for expecting myself to know her entire story and understand her. She still has much to teach me.
Around the conference table sat the eight students in their white coats, with a clinical book passed around to read about the previous patient and her case: scleoderoma.
Um Salem walked in, a short lady, with her head covered, not wearing the regular hospital gown, small arms and feet, round trunk, low voice. She sat at the edge of the chair, put her elbow on the table across from me. There was an air of loss around her: the world barely seemed to exist. The other 10 persons in the room were almost not there to her. She was only brought in to leave as soon as she could.
I speak Arabic, surely, the only Arabic speaker in my group. Shouldn't I be the one to interview her? There is no language barrier and I should be able to understand what Um Salem says.
What steps to keep in mind? At this point of our training, it is supposed to be history of present illness, social and medical history, allergies, medications, family history. Drugs. Okay, I can do this. I think to myself.
After slowly explaining who I am, who the students are, the purpose of our interview, I ask what her name is.Does she understand my accent? Does she remember my name? Is she curious about where I come from? Why I speak Arabic and why my accent is different? None of this seems to matter to Um Salem- she is barely with me in the room as I would ask her questions; she barely maintains eye contact, as she looks throughout the window, around the room, and mutters a few words repeatedly: diabetes, high blood pressure and pain. Do I make my questions more specific? Do I leave it open ended? None of the techniques seem to work and I have no idea what kind of a person is sitting in front of me.
For the first time, I realize when a patient walks into the room, s/he brings more than a disease, a complaint or a cough. S/he brings in a story of the environment of where s/he lives, other people's stories, behaviors and cultures. Pain. Diabetes. High blood pressure. Tin houses. Yes, tests. Then she began coughing.
A classmate tells me, "Ask her for long she has been coughing."A week. The logs....she says. And then our doctor explains what was known as the "Bedouin lung", that because women cook using logs, they breathe in different chemicals, rendering them susceptible for pulmonological complications. Um Salem lives in a tin house, cannot use the logs to stay warm, cannot cook, and has people bring her food. She has been to the hospital before because of breathing problems.
The many words that I have used in Arabic trying to understand her story are not going to provide me with the picture of where Um Salem lives, nor is she going to explain to me about her environment. We come from totally different worlds- and even though I have explained who I am, who the students are, I am not sure that it make any sense to her. I am not sure that my questions about her health, my description of her pain, and her condition make sense to her, at all.
We both speak Arabic and yet the language seems to be common symbols for different meanings, worlds, experiences and lives. After seeing other Israeli patients who are active, who exercise, who do folk dancing, who wanted to get better- Um Salem highlights a complete opposite of the previous realities. Living in a tin house, with no electricity, no running water, not being able to cook, at the age of 70, with certain diseases. How did the world come to be to her?
Another classmate says, "Ask her, Has she been to a local healer?"But, how do I ask her this? It seems that even though the Bedouin population is different than the people in the city, they always use the health care system. She had given birth to all of her children at the hospital. What would I ask her? Do you go see a sheikh so that he makes you feel better? Does he do seher (magic)?
There is no way to translate the question applicable to parts of Africa or South America to Um Salem's situation and language. When you started feeling bad, who did you see first?Kopat Chulim. el mirpaha. Sounding the most awkward and the craziest perhaps to Um Salem, I ask her if she saw a sheikh, knowing that my question does not ask about the same idea that my classmates have in mind.As the interview ends, we, the medical students, have an idea of what her medical condition is and what it is induced by perhaps.
Yet, as she left, I am not sure that I completely understand what Um Salem's diseases is, what she thinks it is, how she comes to see it and experience it. Her lung case, if that is the case, seems to be as unimportant to her as the entire interview. I see her walk out of the room, realizing that though we seem to communicate, I do not know or understand the first thing about her, that though the doctors might give her antibiotic, she probably does not have any idea about what is injected in her and why. If I countmy days by numbers and calendars, she might count hers by the time left for her in the hospital before she leaves. Or, she might never count anything at all. To live in world with no numbers- Possible. I smile As Um Saleem walks away. Um Salem: Sometimes, the spirit of the desert cannot be captured in words, understood or felt. And the grains of sand are not perhaps meant to be measured and counted. Pain. Diabetes. High blood pressure- this is all there was to it. She is right. And I am humbled for expecting myself to know her entire story and understand her. She still has much to teach me.
The streets of lower galilea by me
Dr. Roxana and I just packed our not too sophisticated equipment to measure blood pressure, change bandages and som alcohol and left the clinic to do a house call. Sohpia is an 82 Russian immigrant that medicine desribes as a classic picture of a diabetic patient: diabetic neuropathy, diabetic retinopathy, and now having had her right leg ambuted below the knee two weeks ago. She lives with her brother who is taking care of her. We drive through the durved streets in the neighborhood of Givat Hamoreh, as the Jezreel valley faces us. "Here is Beit Or, where Down Syndrome patients and mentality retarded peopel are dropped off by their family members at the beginning of the day, to be taken care of, to do many activities, and then at the end of teh dya, their famillies come to pick them up," pointed Dr. Roxana to a house on top of one of the hills. "Here, is a beit noar. Boys that came from Russia, Ethiopia and other countries without their parents from a young age until they are teenagers stay here, study until they graduate," was her comment five minutes later.
Dr. Roxana pulled the car on the side of the road, and we walked on the street olazanarov, an old buildling number 26, down the stairs two floors, an man in his 80s welcomed us in Russian. I followed Dr. Roxan, looking at my own lab: the house. There is a sitting room, two bedrooms, a bathroom and a kitchen, very little furniture and old frabric covering the couches. We make it to the room of Sophia, and she is laying in bed, saying hello to Dr. Roxana. I continously hear the one word I recognize in Russian "Da", as the doctor puts on her cloves, changed the bandages, adds antibiotic to the woung, and chats to the patient. I take a look at the room, in front of me is a tank of oxygen near a plant, a poster of "Duet" (they must be a couple from the picture), and behind me is a closet with things packed on top of it. Da. Da. Da. Da. I take a look at Sophia, speaking to the doctor, and yet no focused gaze, a gace I am used while talking to people. The ceiling and the doctor seem to be the extent of her view. She passed chocolate to the doctor. "Practica" is another word I catch. I wonder what they are saying about me. I smile. She passed another paper to the doctor who is still busy with changing the wounds. "Diabetic retinopathy" is the first words that I read.On the way out, the brother shakes hands with the doctor, "Davina," he says. I smile, following the doctor on the way out, who chats with another lady who just came out from the apartment next door.
We walk to the building next, and go up to the second floor. Ethiopian children open the door for us, and the doctor walks purposefully to the room at the end of the house, without giving me time to eye my own lab. We see a lady in her 80s, dressed in a white dress with a pillar of color of blue and red in the front, her head is covered, and she is staring at the wall. We stand there and the granddaughter comes, speaking in Hebrew to her grandmother, asking her to lay down to be examined. The doctor was called because the grandmother was complaining of leg swelling. The grandmother does not move, the daughter comes and speaks in Amaheric to her. Having moved the wheel chair away, we approach her, taking a look at her right foor, always fearing a DVT in an old lady who does not walk much anymore. There is swelling but there is also redness- a skin infection. The doctor asks the daughter to come by the clinic to pic any fungal and steroid antoiment. The grandmother's blood pressure is 130/80. I follow Dr. Roxan, and only eyeball the three little children on the couch, watching TV.
Outside of the dark old building I am faced again by the beautiful shades of green and yellow in the jezreel valley. We drive back to the clinic in Givat Hamoreh that has been there for the past thirty years, serving its low socioeconmic population mainly made up of immigrants. Today, I saw immigrants from North Africa, Russia, Ethiopia but because of passover coming up, the busy clinic was quieter, giving me time to absorb the beauty of the Galilea that was imprinted in my memory when I was a child. I sit back and continue reading an article from IMAJ, "Chossing Primary care? Influence of Medical School Curricula on Career Pathways."
The abstract reads..."in countries in which a primary care-oriented system has developed, general practioners, family physicians and other primary doctor are the keystones of an approach that waims to achieve high quality and satisfction with relatively low cost. Despire this new trend, medical schools still produce execessive numbers of subspecialitists rather than primary care physicians. Among multiple reasons influencing a career choice either towards or away from primary care) instittiona, legislative and market pressures), the present article discusses ways in which medical school curricula may affect students in their preceptions of the role of primary care physicians. Since students are greantly influenced by the cultures of the instutions in which they train, the negative attitude of univeristy towards family medecine may negatively affect the number of students going into this speciality.
Dr. Roxana welcomes another patient, complaining of fever and a sore throat. We take a look at her throat- swallen tonsils and a stong smell comes out, indicating a bacterial cause.
My day is over, and I take a walk back to Afula, with Nazareth on top of a hill behind me, the Jezreel valley to my right and egged buses passing by. That is my lab: an Ethiopian grandmother, a Russian sister, a North African Immigrant, living in old buildings, accompanied by the flowers of april, facing the Jezreel valley. I contemplate whether I am going to walk the Afula curves I had driven through when i was a child to reach Nazareth, if I want to go to Haifa, or if I just want to lay in the grass in Migdal ha emek.
Dr. Roxana pulled the car on the side of the road, and we walked on the street olazanarov, an old buildling number 26, down the stairs two floors, an man in his 80s welcomed us in Russian. I followed Dr. Roxan, looking at my own lab: the house. There is a sitting room, two bedrooms, a bathroom and a kitchen, very little furniture and old frabric covering the couches. We make it to the room of Sophia, and she is laying in bed, saying hello to Dr. Roxana. I continously hear the one word I recognize in Russian "Da", as the doctor puts on her cloves, changed the bandages, adds antibiotic to the woung, and chats to the patient. I take a look at the room, in front of me is a tank of oxygen near a plant, a poster of "Duet" (they must be a couple from the picture), and behind me is a closet with things packed on top of it. Da. Da. Da. Da. I take a look at Sophia, speaking to the doctor, and yet no focused gaze, a gace I am used while talking to people. The ceiling and the doctor seem to be the extent of her view. She passed chocolate to the doctor. "Practica" is another word I catch. I wonder what they are saying about me. I smile. She passed another paper to the doctor who is still busy with changing the wounds. "Diabetic retinopathy" is the first words that I read.On the way out, the brother shakes hands with the doctor, "Davina," he says. I smile, following the doctor on the way out, who chats with another lady who just came out from the apartment next door.
We walk to the building next, and go up to the second floor. Ethiopian children open the door for us, and the doctor walks purposefully to the room at the end of the house, without giving me time to eye my own lab. We see a lady in her 80s, dressed in a white dress with a pillar of color of blue and red in the front, her head is covered, and she is staring at the wall. We stand there and the granddaughter comes, speaking in Hebrew to her grandmother, asking her to lay down to be examined. The doctor was called because the grandmother was complaining of leg swelling. The grandmother does not move, the daughter comes and speaks in Amaheric to her. Having moved the wheel chair away, we approach her, taking a look at her right foor, always fearing a DVT in an old lady who does not walk much anymore. There is swelling but there is also redness- a skin infection. The doctor asks the daughter to come by the clinic to pic any fungal and steroid antoiment. The grandmother's blood pressure is 130/80. I follow Dr. Roxan, and only eyeball the three little children on the couch, watching TV.
Outside of the dark old building I am faced again by the beautiful shades of green and yellow in the jezreel valley. We drive back to the clinic in Givat Hamoreh that has been there for the past thirty years, serving its low socioeconmic population mainly made up of immigrants. Today, I saw immigrants from North Africa, Russia, Ethiopia but because of passover coming up, the busy clinic was quieter, giving me time to absorb the beauty of the Galilea that was imprinted in my memory when I was a child. I sit back and continue reading an article from IMAJ, "Chossing Primary care? Influence of Medical School Curricula on Career Pathways."
The abstract reads..."in countries in which a primary care-oriented system has developed, general practioners, family physicians and other primary doctor are the keystones of an approach that waims to achieve high quality and satisfction with relatively low cost. Despire this new trend, medical schools still produce execessive numbers of subspecialitists rather than primary care physicians. Among multiple reasons influencing a career choice either towards or away from primary care) instittiona, legislative and market pressures), the present article discusses ways in which medical school curricula may affect students in their preceptions of the role of primary care physicians. Since students are greantly influenced by the cultures of the instutions in which they train, the negative attitude of univeristy towards family medecine may negatively affect the number of students going into this speciality.
Dr. Roxana welcomes another patient, complaining of fever and a sore throat. We take a look at her throat- swallen tonsils and a stong smell comes out, indicating a bacterial cause.
My day is over, and I take a walk back to Afula, with Nazareth on top of a hill behind me, the Jezreel valley to my right and egged buses passing by. That is my lab: an Ethiopian grandmother, a Russian sister, a North African Immigrant, living in old buildings, accompanied by the flowers of april, facing the Jezreel valley. I contemplate whether I am going to walk the Afula curves I had driven through when i was a child to reach Nazareth, if I want to go to Haifa, or if I just want to lay in the grass in Migdal ha emek.
Lasote Chaim to make life by me
Sometimes, there becomes a gap of awareness in one's memory, between what one once experiences and leaves an everlasting impression on one, and what one actually rememberes. What seems to outlive one's cognitive memory and make it to one's deepest of selves and its formation is what makes its way to inspire me today through watching the Bedouin old ladies in their traditional embroidered dresses going about doing their business, whether it be in the mall, or at the hospital.
I grew up in a buildling where the woman living on the second floor was the owner of the four comound appartments, and was herself, a fallaha, a peasant who wore similar traditional dresses as the Bedouin old ladies I saw today. The lady, Um Unis, had inherited the buildings and the land from her husband who passed away. Her chilren had immigrated to the States and she would often visit them in Cleveland and then come back, still dressed in her tradiational dress and with her head covered with a white scarf.
It was always a mystery for me to see what kind of hair she had under the white scarf, but since I did not live with her, I never saw her take off the scarf. I remember Um Unis going about in Beit Hanina, the neighborhood where we both lived, attening to her business: builldings, payments from people who owed her rent, the olive harvest of the lands and of course came her health. She never seemed to quiet understand why certain medications were given to her, or why she was sick. So, she would often come see my mother, with whom she was close, bringing a bag of mediations, taking each drug out, asking my mother who could read unlike Im Unis and who also was a medical secretary, what each drug was for, when she should take it and so on.
She would also complain to my mother about those who did not want to pay her the rent they owned, physical pains, her family issues and so on. I was little, perhaps about 6 or so, watching the two women, one skinny and one overweight, talk about a world I did not understand. What lingered with me was not logic or words, but rather colors of Im Unis' embroidered dress, the color of the henna she had on her hand, the white scarf covering her head, the hidden papers and docurments that seemed to always emerge out of her chest, the color of the different medicatation boxes, her placing her hand on her heads, signifying pain and the tone in her voice and my mother's.
I dont remember how Um Unis died because we moved out of the apartment while she was in the States, but a woman in her 60s seems to have inspired me as a woman in my mid twenties to be strong, to carry on with daily tasks, to take care of the land, of the appartments rented out and one's health, somehow. Um Unis comes from my forgotten past back to my cognitive memory through the embroided dresses that I see Bedouin women wearing them today. It wound seem that often one lives in a disposable world, where the old dont matter as much anymore, where cars will drive past them, and nobody will wait for them and their sticks to cross the streeet, and where at a certain age for the sake of productivity and rush in one generation, that younger generation places an older onelin nursing homes and then does not visit them as much anymore.
As a young person, one lives with a feeling of potentual abandonnement, for one does not trust one's age, and somehow know that in old age, one, too, might end up in a nursing home, after having fought life's battles like Um Unis. Much is lost when the older generation is forgotten about. They carry the invaluable wisdom of time, that the young can only attain when they reach the grandparents' age, and their level. The ability of one generation to carry on, to continue to fight, to be reminded of their impernance and yet of their strength to overcome is inspirational to a young person. Grandparents, though wrinkled and disjointed with osteoarthritis, are not fragile. They need to be handled with care, though.
I grew up in a buildling where the woman living on the second floor was the owner of the four comound appartments, and was herself, a fallaha, a peasant who wore similar traditional dresses as the Bedouin old ladies I saw today. The lady, Um Unis, had inherited the buildings and the land from her husband who passed away. Her chilren had immigrated to the States and she would often visit them in Cleveland and then come back, still dressed in her tradiational dress and with her head covered with a white scarf.
It was always a mystery for me to see what kind of hair she had under the white scarf, but since I did not live with her, I never saw her take off the scarf. I remember Um Unis going about in Beit Hanina, the neighborhood where we both lived, attening to her business: builldings, payments from people who owed her rent, the olive harvest of the lands and of course came her health. She never seemed to quiet understand why certain medications were given to her, or why she was sick. So, she would often come see my mother, with whom she was close, bringing a bag of mediations, taking each drug out, asking my mother who could read unlike Im Unis and who also was a medical secretary, what each drug was for, when she should take it and so on.
She would also complain to my mother about those who did not want to pay her the rent they owned, physical pains, her family issues and so on. I was little, perhaps about 6 or so, watching the two women, one skinny and one overweight, talk about a world I did not understand. What lingered with me was not logic or words, but rather colors of Im Unis' embroidered dress, the color of the henna she had on her hand, the white scarf covering her head, the hidden papers and docurments that seemed to always emerge out of her chest, the color of the different medicatation boxes, her placing her hand on her heads, signifying pain and the tone in her voice and my mother's.
I dont remember how Um Unis died because we moved out of the apartment while she was in the States, but a woman in her 60s seems to have inspired me as a woman in my mid twenties to be strong, to carry on with daily tasks, to take care of the land, of the appartments rented out and one's health, somehow. Um Unis comes from my forgotten past back to my cognitive memory through the embroided dresses that I see Bedouin women wearing them today. It wound seem that often one lives in a disposable world, where the old dont matter as much anymore, where cars will drive past them, and nobody will wait for them and their sticks to cross the streeet, and where at a certain age for the sake of productivity and rush in one generation, that younger generation places an older onelin nursing homes and then does not visit them as much anymore.
As a young person, one lives with a feeling of potentual abandonnement, for one does not trust one's age, and somehow know that in old age, one, too, might end up in a nursing home, after having fought life's battles like Um Unis. Much is lost when the older generation is forgotten about. They carry the invaluable wisdom of time, that the young can only attain when they reach the grandparents' age, and their level. The ability of one generation to carry on, to continue to fight, to be reminded of their impernance and yet of their strength to overcome is inspirational to a young person. Grandparents, though wrinkled and disjointed with osteoarthritis, are not fragile. They need to be handled with care, though.
At the sewing machine by me
I dont remember her, though the city of Haifa and she have become associated in my mind. She was named after one of the mountains in Haifa, Carmel. Having been in Afula for the past three weeks, and driven past Haifa and then been to Haifa, she came through my mind. While my grandfather, Abu Abdo, was from Bethlehem, a city in the West Bank that is close to Jerusalem, and he lived there almost all of this life, the story with my grandmother, Im Abdo, was different.
The only remenant connection to her home, the north, nanely Shfa Amer, remained through her cousins who would occastionally come visit her and her family in Bethelhem. Still, till today, her family of Nasrallah is prominent in Shfa Amr. By getting married, moving to a husband's house, and starting a family, I had the feeling that a part of a woman's story, at least my grandmother's story, becomes blurry, and in time, forgotten. Mother's stories are passed down, sometimes through their daughters, especially when they only have daughter. Wisdom leavened a mystery in women, their bodies, their stories.
The story has it that my grandmother, Carmel, escaped in 1948 with her family from Shfa Amer to Lebanon where she lived until she moved back to Bethelhem having married my grandfather, Abu Abdo. I still have cousins living in Lebanon, part of the Nasrallah family. But with no internet and the dispersed letters and pictures sent of the news of cousins, my grandmother's family, story and so on seem to have gotten lost somewhere between Lebanon, the north of Israel and the West Bank, on this very mountain in Haifa after which she was named: Carmel.
My aunt gave my mother some pictures that my grandfather, Abu Abdo, had taken throughout his life. My grandfather was a historian who continously documented everything from family life, religious celebrations and so on with his camera. Posing for the camera was annoying, especially during winter time when I would have to look at his head and the warm hat he always wore. The pile of pictures left in my mother's drawer had some dates, but not all.
Family from Lebanon, grandmother and daughter in Iraq, more people I did not know, black and white pictures. And then came the picture that remained imprinted in my memory, leaving its effects without remembering the story, much like Carmel's story was also fogotten. The picture was taken around the early ninties, and I must have been 10 or 12. Carmel was lying on the couch, dressed in her PJs, looking at the camera, at my grandfather, Abu Abdo. I was sitting accross from her at the couch, and we were playing tunj, a card game she would always beat me at! It was a family tradition to play tunj, and Carmel was known to win. I looked at the cards on the couch, remembered my evident defeat, despite my deterimination to win. Carmel was a master at tunj!
The next picture, she had drawn me near her, standing, with wraped gifts, and we both posed to my grandfather for yet again another picture. It was christmas time, the exciting time to get gifts, and yet a fear lingered inside of me at the time, among the pile of cards on the couch next to my grandmother, Im Abdo. It was cold and rainy in Bethelhem and I had somehow known that it might be her last christmas with us.
She had been diganosed with "that disease whose name we cannot mention", a few years ago, and went through surgery. She was in her early 60s, about twenty years ago, when breast cancer and its treatment were not that well known or even accepted in the community in Bethelhem. She refused to have chemotherapy and had a bilteral mastectomy in Augusta Victoria hospital in Jerualem. At the time, it was easy for people living in the West Bank to reach Jerusalem.
What remained with me as a child of Im Abdo was her look, her smile and her hands. She was a tailor who learned it from her sister, Rose, who took lessons for it. Im Abdo owned a sewing machine that she kept in the bedroom of my aunt, and she would often sew my own clothes. She was the first one to introduce me to velvet fabric, having made me and my sister our dresses.
Sitting at her sewing machine, she would take out her measuing meter, wrap it around my waist- the way I do it with my patients to measure their waste. She then would measure the length from my waste to my feet, the length from my chest to my arms and write down the measurements. It was a delight to get a new dress that she had made. She was not much of a story-teller like my grandmother Im Saleem, but the noise of the sewing machine, while i rocked my baby sister in her pram, remains with me till today.
Her fine eye for detail, her soft hands that measured my 6 year old body remained with her on that christmas eve as we both posed for the picture. "You have grown so much," she said, having been 10 and yet with a body of an older teenager. She turned me around for the picture but this time, she was not eyeballing my size to make another measurement for another dress. My grandfather, Abu Abdo, took another picture.
Today, I am a tailor myself, constantly eye balling people's bodies, doing measurements and sitting at my own sewing machine like Carmel Nassrallah, Im Abdo, used to do.
The only remenant connection to her home, the north, nanely Shfa Amer, remained through her cousins who would occastionally come visit her and her family in Bethelhem. Still, till today, her family of Nasrallah is prominent in Shfa Amr. By getting married, moving to a husband's house, and starting a family, I had the feeling that a part of a woman's story, at least my grandmother's story, becomes blurry, and in time, forgotten. Mother's stories are passed down, sometimes through their daughters, especially when they only have daughter. Wisdom leavened a mystery in women, their bodies, their stories.
The story has it that my grandmother, Carmel, escaped in 1948 with her family from Shfa Amer to Lebanon where she lived until she moved back to Bethelhem having married my grandfather, Abu Abdo. I still have cousins living in Lebanon, part of the Nasrallah family. But with no internet and the dispersed letters and pictures sent of the news of cousins, my grandmother's family, story and so on seem to have gotten lost somewhere between Lebanon, the north of Israel and the West Bank, on this very mountain in Haifa after which she was named: Carmel.
My aunt gave my mother some pictures that my grandfather, Abu Abdo, had taken throughout his life. My grandfather was a historian who continously documented everything from family life, religious celebrations and so on with his camera. Posing for the camera was annoying, especially during winter time when I would have to look at his head and the warm hat he always wore. The pile of pictures left in my mother's drawer had some dates, but not all.
Family from Lebanon, grandmother and daughter in Iraq, more people I did not know, black and white pictures. And then came the picture that remained imprinted in my memory, leaving its effects without remembering the story, much like Carmel's story was also fogotten. The picture was taken around the early ninties, and I must have been 10 or 12. Carmel was lying on the couch, dressed in her PJs, looking at the camera, at my grandfather, Abu Abdo. I was sitting accross from her at the couch, and we were playing tunj, a card game she would always beat me at! It was a family tradition to play tunj, and Carmel was known to win. I looked at the cards on the couch, remembered my evident defeat, despite my deterimination to win. Carmel was a master at tunj!
The next picture, she had drawn me near her, standing, with wraped gifts, and we both posed to my grandfather for yet again another picture. It was christmas time, the exciting time to get gifts, and yet a fear lingered inside of me at the time, among the pile of cards on the couch next to my grandmother, Im Abdo. It was cold and rainy in Bethelhem and I had somehow known that it might be her last christmas with us.
She had been diganosed with "that disease whose name we cannot mention", a few years ago, and went through surgery. She was in her early 60s, about twenty years ago, when breast cancer and its treatment were not that well known or even accepted in the community in Bethelhem. She refused to have chemotherapy and had a bilteral mastectomy in Augusta Victoria hospital in Jerualem. At the time, it was easy for people living in the West Bank to reach Jerusalem.
What remained with me as a child of Im Abdo was her look, her smile and her hands. She was a tailor who learned it from her sister, Rose, who took lessons for it. Im Abdo owned a sewing machine that she kept in the bedroom of my aunt, and she would often sew my own clothes. She was the first one to introduce me to velvet fabric, having made me and my sister our dresses.
Sitting at her sewing machine, she would take out her measuing meter, wrap it around my waist- the way I do it with my patients to measure their waste. She then would measure the length from my waste to my feet, the length from my chest to my arms and write down the measurements. It was a delight to get a new dress that she had made. She was not much of a story-teller like my grandmother Im Saleem, but the noise of the sewing machine, while i rocked my baby sister in her pram, remains with me till today.
Her fine eye for detail, her soft hands that measured my 6 year old body remained with her on that christmas eve as we both posed for the picture. "You have grown so much," she said, having been 10 and yet with a body of an older teenager. She turned me around for the picture but this time, she was not eyeballing my size to make another measurement for another dress. My grandfather, Abu Abdo, took another picture.
Today, I am a tailor myself, constantly eye balling people's bodies, doing measurements and sitting at my own sewing machine like Carmel Nassrallah, Im Abdo, used to do.
Queues by me
I had never really lived in Israel proper until I moved back to Beer Sheva to attend medical school. Experiencing the negev with a mixture of Americans (Jews and non Jews), Israelis and the occasional Arabs (be it from the north, or from the negev) seems to have left me many a time in a state of wonder.
For example, I have long wondered what a bomb shleter is, where it is at. "The dancing class is at the bomb shleter in the neighborhood gimel...My room in the dorm is in the bomb shelter, it has a double door..." That is as far or as close as I dealt with bomb shelters. Of course, there is the occasional flight of helicopters, and shelling that I might hear accross from the not so far away border, Gaza.
Growing up in my neighborhood in Jerusalem, I somehow understood that to be respected, to be considered to have accomplished much in life, one has to be able to build. That applied to most Palestinians living in East Jerusalem or in the West Bank. And to build, one also had to have a land. Building a house, which takes time and effort, is a family event, a right of passage, of perhaps moving out of parents' houses, or of building more of a permanant house so that children and their spouses could move in some day. I dont remember any of the building that I had been to having to have a special or a certain room.
I do remember, however, the need for a permit to build in East Jerusalem. Permits are very hard to grant, and thus prices of lands, of rent and anything to do with building goes up. Of course, there is always the person who had been waiting for a permit for years, and then would finally give up on getting it and build anyway. Such a person was a neighbor once, and it was horrific to wake up one morning and realize that the building where he lived was gone while he was at work, with his wife outside, sobbing, and the army in its jeep also outside as rocks and bricks were now in no certain structure except for chaos. Of course, there also would be another reason for a building to be destroyed, as a punishment for an entire family if their son was found to be a suicide bomber. The family near us at the time said that they did not know their son was involved in such events, and only woke up to a man, knocking on the door, telling them to evacuate.
All this is say that I have never known what a bomb shelter looks like but only heard about it from people. I live in neighborhood in Ramot in Beer Sheva, on the third floor. The other day, with the windows open, the door of my office room was slammed shut while i was inside. The door knob for this door, which I had never paid attention to until I had to open the tighty jammed door, is different than the other door knobs in the house. It is metal, and can be turned up and so lock the door without having a key. I struggled to turn the door knob down, to come out of the room. Feeling sealed inside of my own room, wondering how i could reach someone to help me if I did not have a phone in my room, I finally thought, "Oh, I must have set up my office room in the bomb sheleter all of these years. This is why when I go study there, I cannot hear a voice, a sound or anything. I wanted to be the isolated when I was studying!"
Many a time I think to myself that I have preserved being Palestinian, my story and so on. And yet it is at times of discovery like these that I realize that by moving here, many parts of me are changed beyond awareness, beyond negociations, beyond a doubt, and beyond an argument. Yesterday, was Israel's independence day. I had gone out to have a meal with a friend that I had not seen for a few years. We went to Naffi's, and had to wait in a queue because of all of the people waiting to be seated. "Strange," I thought, "I had stood in queues, on this same day, but showing my papers to soldiers and policemen to allow me to pass, or trying to perculate through demonstrations back to my own house."
"Chag Sameah," said the waitress as I left with my friends. I smiled wondering how many more bomb shelters I do live in without knowing. Queues have mysterious reason and timing to be formed, to be joined and to be passed through.
For example, I have long wondered what a bomb shleter is, where it is at. "The dancing class is at the bomb shleter in the neighborhood gimel...My room in the dorm is in the bomb shelter, it has a double door..." That is as far or as close as I dealt with bomb shelters. Of course, there is the occasional flight of helicopters, and shelling that I might hear accross from the not so far away border, Gaza.
Growing up in my neighborhood in Jerusalem, I somehow understood that to be respected, to be considered to have accomplished much in life, one has to be able to build. That applied to most Palestinians living in East Jerusalem or in the West Bank. And to build, one also had to have a land. Building a house, which takes time and effort, is a family event, a right of passage, of perhaps moving out of parents' houses, or of building more of a permanant house so that children and their spouses could move in some day. I dont remember any of the building that I had been to having to have a special or a certain room.
I do remember, however, the need for a permit to build in East Jerusalem. Permits are very hard to grant, and thus prices of lands, of rent and anything to do with building goes up. Of course, there is always the person who had been waiting for a permit for years, and then would finally give up on getting it and build anyway. Such a person was a neighbor once, and it was horrific to wake up one morning and realize that the building where he lived was gone while he was at work, with his wife outside, sobbing, and the army in its jeep also outside as rocks and bricks were now in no certain structure except for chaos. Of course, there also would be another reason for a building to be destroyed, as a punishment for an entire family if their son was found to be a suicide bomber. The family near us at the time said that they did not know their son was involved in such events, and only woke up to a man, knocking on the door, telling them to evacuate.
All this is say that I have never known what a bomb shelter looks like but only heard about it from people. I live in neighborhood in Ramot in Beer Sheva, on the third floor. The other day, with the windows open, the door of my office room was slammed shut while i was inside. The door knob for this door, which I had never paid attention to until I had to open the tighty jammed door, is different than the other door knobs in the house. It is metal, and can be turned up and so lock the door without having a key. I struggled to turn the door knob down, to come out of the room. Feeling sealed inside of my own room, wondering how i could reach someone to help me if I did not have a phone in my room, I finally thought, "Oh, I must have set up my office room in the bomb sheleter all of these years. This is why when I go study there, I cannot hear a voice, a sound or anything. I wanted to be the isolated when I was studying!"
Many a time I think to myself that I have preserved being Palestinian, my story and so on. And yet it is at times of discovery like these that I realize that by moving here, many parts of me are changed beyond awareness, beyond negociations, beyond a doubt, and beyond an argument. Yesterday, was Israel's independence day. I had gone out to have a meal with a friend that I had not seen for a few years. We went to Naffi's, and had to wait in a queue because of all of the people waiting to be seated. "Strange," I thought, "I had stood in queues, on this same day, but showing my papers to soldiers and policemen to allow me to pass, or trying to perculate through demonstrations back to my own house."
"Chag Sameah," said the waitress as I left with my friends. I smiled wondering how many more bomb shelters I do live in without knowing. Queues have mysterious reason and timing to be formed, to be joined and to be passed through.
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